Among long-term crack smokers, who avoids and who succumbs to cocaine addiction?

Crack cocaine is recognized as a highly addictive drug. To learn more about who becomes addicted to crack, we compared long-term users who had never met the DSM-IV criteria necessary for a diagnosis of lifetime cocaine dependence with those who had. Data for this cross-sectional study of 172 users were extracted from a natural history study of crack users in the Dayton, Ohio, area who were interviewed periodically over an 8-year period.Interviewer-administered, structured questionnaires were used to collect data on a range of variables, including age of crack use initiation, frequency of recent crack use, and lifetime cocaine dependency. Lifetime cocaine dependency was common with 62.8% (n=108) having experienced it. There were no statistically significant differences between dependent and non-dependent users for age of crack initiation or frequency of recent crack use. Sociodemographically, only race/ethnicity was significant, with proportionally fewer African Americans than whites meeting the criteria necessary for a dependence diagnosis. Controlling for sociodemographic characteristics, partial correlations showed positive, statistically significant relationships between lifetime cocaine dependence and anti-social personality disorder as well as attention deficit/hyperactivity disorder and lifetime dependence on alcohol, cannabis, amphetamine, and opioids. The results highlight the importance attending to race/ethnicity and comorbid disorders when developing, implementing, and evaluating intervention and treatment programs targeting people who use crack.